Sunday, May 27, 2012

Haunted by the supernatural - A shy girl's dream

A young woman who just turned 31, still single, reported the following dream:

A supernatural force is chasing me and another boy and a little two and a half year old baby. The older two of us are like protecting the younger one. We run to hide on a bed and cover ourselves with a white comforter. But the force emerges from behind us as two cocoon like figures shrouded in white sheet and quivering from top to bottom - she made motions of quivering with her hands to give expression to how those wavering figures appeared. One of them looks just like me. Both have brown hair. At that point I become evil myself. My eyes pop out of their socket. The white of the eyes become cone like and the pupils turn into points of a pen. I begin to write with those coney eyes on a big white thing, may be a big piece of paper. The writing is dripping with blood.

Isn't the dream crazy? she exclaimed and then added that the force remains in the background, camouflaged, and only steps out ever so briefly, but without actually harming us. Throughout the dream we are hiding from it. At one point instead of the boy a girl is accompanying me.

"It all made sense while dreaming but now it sounds so weird. I forget most of the finer details. If only I could remember all of it it would make such a fantastic movie."

"Who was the boy with you with whom you were taking care of the baby?"

"Actually he was pretty insignificant in the dream. His presence does not matter."

"Even if he appears insignificant to you, the fact that the dream chose to give it a representation means something significant lies behind it."

"That is not true about my dreams. All kinds of insignificant and inconsequential people appear in them. For example the other night a coworker of mine who I have no feelings for and couldn't care less about - don't mistake me he is not bad looking or anything like that -  was my husband in my dream and we had a child together who I was taking care of. Now there could be no reason for the dream to show this man as my husband. And then he and I having a child?! Having children is farthest thing on my mind. So my dreams can be full of insignificance."

"Well if the dream censor objects to our motives and emotions which are trying to make their way to fulfillment in the dream towards a significant person then the dream-work will try to fool the censor by substituting an insignificant person for the former. There may be guilt associated with seeing the significant person as your husband and father of your child so you have substituted this insignificant person for him because in real life you have no feelings for him. The dream censor (conscience which never fully sleeps even while dreaming) will be clueless as to what is going on with such a deception and will allow the dream to proceed as something innocent and will not wake you up.

"Who could be such a significant person who I cannot even dream of being my husband and the father of my child?"

"Girls often have fantasies of getting a child by their father, and there is always guilt associated with such fantasies.  Recall how one of your earliest memories is of your father driving away after your parents got divorced. And you told me how when you were three or four you were like your father's shadow. On your weekend visits you went everywhere with him and could not bear to be separated."

I was also familiar with some other facts about the girl which gave me reason to make the above construction. She once had a dream as a little child where she had sneaked in to her father's bedroom and could see what he was dreaming. He was dreaming of a  bustling city that was hovering above his bed. A kind of floating city where all the daily activities and concerns of mankind were taking place. The dream was interpreted as her wish to make her and his dreams to co-mingle and make a dream world/city/life of their's together. Her father never married after he divorced her mother, and growing up at times she felt sorry for him and wanted so much for him to have a family life of his own

"The boy who was with me had brown hair," the girl recalled.

The psychoanalytic commentary had brought out a fragment of the dream out of amnesia/repression and  now she could add that detail.

"What pictures or memories come to the mind when you think of the brown hair?"

"All my brothers have brown hair. Just like me. Mine is a little lighter. My mother's hair was brown too but darker than me,  like my brothers'."

"Is that boy then your brother?"

"Yes, he is."

"Why do you say that?"

"Because the little kid whom we were saving was my brother too. At one point in the dream he said, "Don't leave me, for I will die."  So it was me, and the brother next to me, who were saving the youngest one from some disaster. The dream was end of the world kind of dream. Like you see in those apocalyptic movies where everything is destroyed and only a handful of people are left who band together and watch out for each other. We were such a leftover group, my two brothers and myself,  trying to survive, running away from the supernatural force which was following us."

Knowing her I knew the greatest disaster of her life had been the sudden death of her mother when she was still quite young. I asked her, "Is the dream a replay of the disaster of your mother's death."

"Could be.  Her death was in a sense like end of the world for us children. And though we still had our step-father, it felt as if we were small, weak and helpless against the big world. And while growing my mother had at times told me that if something happens to her I must take care of my brothers. I always felt responsible for them. When she died, in many respects, I took her role with them."

"How old was the little kid you two were taking care of?

"Two and a half years."

"How old was your youngest brother when your mother died?

"Two and a half years."

"Who are the two figures whom you ran for refuge but who paradoxically change into the supernatural entity itself and rise out of the bed.?"

It was easy to see that they had to be familiar figure to whom they were running to to escape from the disaster only to find that they had inadvertently ran into what they were running away from.
"I don't know. They rose from the back and as if they were part of the comforter, like blended into the comforter. One of the figures looked like me. She had brown hair similar to mine."

"Was she your mother?"

"I don't know about that. But my mother had brown hair and blue eyes like I have. She was very pretty, my mother, and I am vain too like her." She gave a shy smile. "And now a memory comes up, so here is your associations which you are asking of me. Someone my mother dated in high school I ran into him when I was visiting my hometown, and he gasped with astonishment at the resemblance and said that it is so spooky how you look just like your mother. Everybody was crazy about my mother because she was so pretty."

"So at least one of the two figures following you is your mother. But why would she be evil towards you? Is it possible that her premature death has generated guilt in you especially since because of it you had to take her role? Also by mothering her other children, you symbolically replaced her with your step-father. You have told me that you are very attached to your step-father as well, similar to the way you were attached to  your father. And you are afraid that she has turned evil because she had to abdicate her role to you. Maybe somewhere in your unconscious thoughts you must think she will come back from the afterlife to punish you for displacing her."

"I think those entities about to emerge out of the woodwork are there more to keep an eye on me to make sure that I am doing the job right by my brothers than to punish me. Actually the entities were not evil. They were like in the background and followed us but never quite harmed us. So I should not have said they were evil. But there got to be guilt in me about her death. For just before dying she had developed severe blood pressure due to a problem in the artery that went to her kidney. My stepfather's family is very well off, so they went to Mayo Clinic for evaluation. The doctors there told her that if she does not get operated immediately she will die in 2 weeks. She had the operation and nevertheless died in two weeks.  As if she was destined to die on that day no matter what. I feel guilty because like I knew that that was going to happen to her that day.

"And now I am deathly afraid that I am going to die too and at the same age as my mother did and from the same condition."

"What condition?"

"A heart condition. It is genetic. Our heart suddenly stops."  Here she made the same wavy motions with her hand that she had made to give expression to the quivering ghosts who had risen out of the bed.  

"How do you know it is genetic?"

"Because my grandfather, her father, died from the same heart condition, at the same age, and without warning."

"Is the other figure who rises up from the bed is he your grandfather?"

"I don't know. The figure was of an older man. Could have been my grandfather. Never saw him alive though. Just a picture of his. He died before I was born. Died at the  age of 41 too, just like my mother. And yes in that picture his hair was dark brown like that of the dream figure." 

"Is the disaster you are running away from is it the fate of your mother and grandfather? Your own death?"

This conjecture could be more boldly advanced because the white shroud, the white comforter they were all per psychoanalytic theory allusion to death.

"That is deep, but you are right. The fear that their fate awaits me is always present  in the back of my mind as a disaster about to happen.  That is the reason I avoid doctors. I don't leave home unless absolutely necessary. As if I am safer in my home from the down worlders. I have coined that term to give pictorial expression to my fear of ghosts, ghouls and other entities from the world of shadows. Another term that I have coined." 

"Why did you turn evil at the end?"

"That is a good question. There is a dark side to me. It never finds expression nowadays, but once upon a time I was mean little girl who could be spiteful and vicious. I wouldn't like to know me the way I was in high school. I am nothing like that anymore. In fact just the opposite." 

"Is it possible that this mean part of you that you have successfully conquered during the day still manages to come out in the night in your dreams? And this mean streak in you found an outlet in anger towards your mother for dying prematurely and burdening you with the responsibility of taking care of your brothers and your step-father? She left you, an only girl amidst three brothers and the step-father. That may explain why your mother and grandfather are haunting you. For if you are angry towards your mother then you may harbor fears that she will come to punish you. And the dream is giving a pictorial representation of this fear of them."

"Why would I be angry towards my mother for dying early. She had no choice over it."

"But that is not how the unconscious thinks. The child part of your unconscious mind may not reason rationally and still hold a grudge against your mother for abandoning you when you were ill prepared to take up all those responsibilities."

"I guess at times when I was young I did feel anger towards your mother. And perhaps you are right in that I no longer feel angry but sad. I am strange with my emotions. I feel them not quite the same way that they should be felt. They change in me. Often I feel opposite of what I should feel. When I am missing somebody like when I broke up with my boyfriend instead of missing him and getting sad I got angry and mean towards him. With my mom perhaps it happened the other way instead of feeling angry I felt sad and fearful. 

"But now a dream comes to my mind. The other night I saw in dream this girl who I was trying to punch. But however hard I tried to hit her it did not count. For before my fist could make contact they lost power. As if I was hitting a punching doll and the impact had no effect. It was like nothing could happen to her."

"Who was this girl?"

"This girl was my old best friend. We had a fall out and we have not been friends for 10 years. We were like sisters."

"How long ago your mother died?

"10 years."

"So could young fall out with her was a reaction to your mother leaving you? Since your mother left you, you left your best friend as a retaliation."

"That is so interesting. Because the reason I broke up with her was because she did not come to my mother's funeral. She betrayed my mother."

"Just like you felt your mother betrayed you."

"Perhaps. But she definitely betrayed my mother. For her graduation my mother gave her 500 dollars. No one gives that kind of money for somebody who is not even their daughter, and she went on to a spring break with her boyfriend instead of coming to her funeral."

This could not be communicated and confirmed with the girl, but it looked that behind the rage and desire to punch her best friend for betraying her mother lay her own guilt of betraying her mother. In one of the sessions she stated that she feels guilty all the time; feels God will not forgive her; even after going to church and confessing to God and being reassured that God forgives all sin she could never feel pure or at least not for too long,; and that when she was a little child just telling a lie to my Mom made her feel as bad as murdering somebody.  This was an unmistakable allusion to her repressed death wishes towards her mother. 

And in her dream she could not punch her girlfriend with any force for she too harbored the same wish in her unconscious. To betray her mother and to replace her in the household.  It was like the female version of "Hamlet". Hamlet could not kill his uncle for killing his father and sleeping with his mother because he harbored the exact same wishes. 

But there appeared to be another wish behind punching her friend. It was giving vent to her anger at her mother for dying prematurely. The friend was substituting for her mother. 

"Why do I not connect and hit her when I want to hit her as hard as I can?" she asked.

"If she represents your mother then the opposite impulse arising from filial piety prevents you from doing the unthinkable."

"Yes, I do have two contrary impulses. For in the dream when I turned evil it was just part of me that turned that way. While another part of me just continued to be the onlooker.  The good part of me, the onlooker, was horrified at the emergence of  those coney bloody eyes. And all the while I was turning evil I was determined to run away from the bad guys and not become like them. There are two sides of me a  weaker scared side which joins the good guys and an evil one which sides with the bad."

I could not confirm it with the girl, for we ran out of time, but to me the coney bloody eyes derived their prominent representation from her especially strong scoptophilic instinct. The need to look at everything with great curiosity. The instinct which reaches its zenith during the sado-masochistic phase of  infantile sexuality. The popping out of her eyes was representation of her eyes popping out with jealousy over the privileges that her brothers enjoyed which being a girl she was denied growing up

She confirmed the conjecture that that part of the dream had something to do with envy "for you have to realize I grew up in UP, they are Neanderthals there when it comes to treating girls versus boys. And everybody else, my three siblings, my father and step-father, they were all big outdoorsy guys. And here I was not even allowed to mow the grass. Not allowed to shoot. Even snowmobiling, they let me do it just once. Yes, I did think that way that life was more cool if you were a boy. I am not gay or anything like that. I love men. I guess having that kind of jealousy has nothing to do with sexual orientation."

"Is it possible that behind the jealousy lay some impulses to violently hurt your brothers to get even for your mother making you a girl while she made all other siblings of yours as boys."

"I don't think so. But who knows what lies in my subconscious. For once upon a time I could be superviolent if provoked." 

"Is your current excessive shyness a reaction to his superviolent streak, keeping it buried by your building a wall of shyness and avoidance around you?"

"Perhaps. For you know how much I fear people."

"Is the blood dripping from your coney eyes a muted expression of this hidden violent impulses towards your brothers?"

"I don't think so. It could be. Though for me writing in blood symbolizes doing something that is carved in stone. Something whose fate is sealed in blood. It is final, like blood brothers; like blood oath."

And both of us wondered if writing with blood on that white paper in the dream was an attempt on her part to undo the fate she feels is written in stone. A fate that will strike her with cardiac arrest as it did her mother  for having once harbored evil impulses towards the latter and which in her unconscious she believes had a  role in causing her mother's death. For the girl does suffer from obsessive compulsive problems and does read and write all the time, perhaps to change the course of her life from its beginning. 

Friday, May 25, 2012

Restless Leg Syndrome, Cracking of joints, Fibromyalgia, Catatonia: different manifestations of Obsessional Neurosis

A young man, now  21, developed severe obsessional neurosis at the age of 16 when a disfiguring bone tumor emerged on his left upper arm. The tumor, though benign, could not be removed right away because the growth plate next to it had not matured and early resection would have shortened the arm. So he had to live with this growing menace for a couple of years before the surgeons finally went in and removed the unsightly growth.

 During this waiting period, the obsessions grew by leaps and bounds.

In the session the patient insisted, and the mother who came with him, agreed that the whole of his mental problems could be accounted for as a reaction to the  emergence of this misfortune. But a more careful history taking revealed that he was given to severe temper tantrums even earlier, and in fact they were already so severe by the time he was 13 that in his fits of anger he would put holes through the walls of his house, one time he had shattered a flat screen TV, and mother added that every cell phone bought for him had been smashed via getting violently hurled upon the floor.

It was easy to see that the narcissistic injury that had changed this wellspring of anger to frank obsessions was the disfigurement - the tumor was very embarrassing and scary to him - but its pathological strength appeared to have been derived from the repressed wish  for the misfortune to have struck his younger brother instead of him. This younger brother was his rival from the earliest childhood. His earliest memory is of his rage at his brother and the  first time he put a hole in the wall was when he saw his brother wearing his clothes.  

The patient then gave a whole series of obsessive symptoms which were all manifestations of saving his mother from his death wishes or getting even with his father. These obsessions the patient had to admit were present even before the tumor emerged. From a young age he would check and recheck the stove twice, and sometime three times, to make sure that some bad luck does not befall his mother or him or his entire family.  Patient added that it is crazy for he loves his mother very much so he does not understand why he is preoccupied with her death.

The patient then shifted to describing his obsession with symmetry which were to get even with his father who had left the family when he was 2. Anything that was done towards right side - all activities had to be initiated by the right hand - had to be countered by similar action towards the left. Also the number of times something was done towards the right side had to be counter-balanced with exact same number of times towards the left.  He then added that this obsession for symmetry is what lies behind his Restless leg Syndrome. He may spend hours moving his body right and then left, leaving him awake and exhausted through the night.  His mother added that yes, he has RLS. It is painful to watch him in his bed, for he  moves his leg this way and then the other way all night long, vainly trying to fall asleep and even after he falls asleep, often the movements continue.

Patient added that his Restless Leg Syndrome extends to his hands as well and coming to think of it to his whole body and that Restless Leg Syndrome is just a mini-version of Restless Body Syndrome. "I am always on the run, day and night, and my body is still running mentally as I lay there in bed. Restless Leg Syndrome is nothing but my running away from the disaster that is about to happen to me or my family." He then gave some details of his Restless Hand Syndrome. He had to  move his wrist in clockwise and then counterclockwise direction. This process started with having to make wrist motions to make sure that the stove is turned on and off : starting the fire and then undoing it.

All these movements causes constant muscle tension and pain which is only relieved when he cracks the joints. Patient said that the cracking of his joints gives him pleasure and it is part of his OCD. It is no different than checking and rechecking the stove.  He demonstrated this cracking of joints, which were, as claimed, impressively loud, in his knees and neck. He did not say so, but the way he described his body aches and pains they could easily be viewed as fibromyalgia.

When asked why he has to crack the joints, the patient claimed the tension in his muscles locks them up. In my mind this raised the thought that catatonia itself perhaps is no more than an extreme form of muscular intent in cross purposes rendering the person immobile (catatonic) - and mobility is restored to them only if the joints to which they are attached is cracked.

That the cracking of joints is a from of OCD is furthered bolstered by the following case that I saw recently.

A 15 year old girl, who is depressed for years over her parents separation and their neglect of her, and who because of her overweight gets bullied at school, and who fights with her sister all the time to discharge her aggressive impulses, reported that she has a tough time stopping herself from cracking her knuckles.

She gave the usual explanations that it is a habit, that it makes her feel good, but there was little doubt that it was continuation of her obsessional defenses. For every time she cracked her knuckles in her right hand she had to do it in her left in a symmetrical fashion. At one telling demonstration in my office she cracked her knuckles, then touched the mobile phone which she was holding between her thighs and which was sticking up from her pubic area as a symbolic penis, and then symmetrically touched her right and left knees. The touching of the upstanding phone was no different than how obsessive-compulsive must touch a particular part of the body which is symbolic of the penis every few minutes. In many obsessives the touching is quite openly of the genital area.

Thursday, May 10, 2012

Dream of a delectable unique fruit

A young girl not yet out of her teenage years and full of self-doubt about her self worth and who thinks of herself as lacking in something despite being very pretty and attractive dreamt the following:

I am in downtown. I am with a bunch of kids from school. None of them are really my friends. I know them but none of them I can really call  as friends. Then we come to a fruit-shop. I enter inside. There is a fruit there like no other. It is green and it is not like any other fruit.  I cannot name it. I eat just a little of it for I don't want to finish it. For then that fruit will not be there.  

"Why the dream chooses the downtown as its venue?"

To this she said it was not Detroit downtown but Chicago. Associations showed that she wants to pursue her studies in Chicago after graduating. The dream was showing this wish as  already fulfilled.  However, she has mixed feelings about leaving Michigan for she would have to leave her friends behind. The dream was showing this objection too as "yes you have friends to hang around with in downtown Chicago but they really cannot be looked upon as your friends.

She could come up with no associations to the fruit-shop or the fruit. All she could tell was that the fruit was like a peeled orange with the white fibers that surround the pulp still there but it was not shaped like orange but like a tear drop. The white fibers and tear shape raised the possibility of it being considered the genitals but this thought was held back from expression. Instead I asked her to retell the dream. The way she narrated the dream again made me think that eating of the fruit had to to do with sexual satisfaction. Eating sweet things in dream is often symbol of sexual satisfaction and body parts are often presented as fruits.

This time she added two new elements. To enter the fruit-shop she had to climb down a flight of stairs. And the fruitship was tripartite. There were three rooms to it and the center room was made of glass.

Now climbing up or down flight of stairs is perfect symbol of sexual intercourse - mounting/climbing the sexual object - and looking through glass, arising out of scoptophilic instinct, usually depicts curiosity about sex.

"Did you have sex that night?"

The patient who is quite young and had never talked about her relationships intimate or otherwise hesitated our of embarrassment and then judging that I had no prurient interest in the enquiry confessed, "Yes, I have a new boyfriend. I don't know I should name our relationship to be that. I don't know how to name it. I am more into him than he is in to me. But yes, we did have sex on the evening of the dream. And it is strange that he too had a dream that night. He never dreams, but he did that night because I gave him an amethyst when he parted and that amethyst must have made him dream - because amethyst is my birth stone which will bring him good luck and protect him. His dream was also about being in downtown with a group of people. But his dream was full of fear. They were stopped by the police who accused them of doing something wrong. Somebody then shot him in the arm which was so painful that it woke him our the dream/sleep.

Without getting side-tracked into her boyfriend's dream which appeared to be punishment for his having had sex with her, I asked her if not being able to name the one-of-a-kind fruit was not derived from her inability to name their relationship as being that of a girlfriend and boyfriend..

She immediately confirmed it  by saying that she has been wondering as to how to label their relationship. It is not casual friendship but not yet so intimate as to be termed as a boyfriend-girlfriend relationship.

"Why the fruit-shop has three rooms?"

"It was not quite three rooms. There were two sections on either side of a glass enclosure that had the fruits."

Was she describing the two buttocks and the genitals were being depicted as the unique fruit? This conjecture could not be approached and confirmed because of the delicacy of the subject.

"Why is the fruit green? Was the amethyst you gave him green?"

"No, amethysts are purple." But she came up with another element of the dream that she had not described so far. Her best friend M was with her and she allowed M to taste the fruit a little bit too.

This led to the theme of jealousy for green is often symbol of jealousy. So she was letting her best friend get a taste of her experience, partly to make her jealous, partly to share the experience.

So the dream was about enjoying her sweet tasting body (one of a kind fruit) through the eyes of her lover. The girl agreed with the interpretation.

Wednesday, May 2, 2012

Childhood sexual trauma revisited in two dreams

A young girl brought the  following two short dreams in succession.

1st dream: I meet a football player. He is very handsome. But awkward and nerdy. He keeps telling me how beautiful I am. He is overly interested in me. Tells me how cute and attractive I look. I tell him that I cannot have a relationship with him because I am committed to someone.

The patient immediately added that even in the dream I knew he was exaggerating his praise of me, and then proceeded to tell the second dream which at that moment had suddenly popped up in her head.

I am with my younger sister. She is asking me to do methamphetamine with her. I am refusing it. I  tell her it is stupid. Then I hear children laughing. There are 5 of them. But two do not have faces to them.

I asked her if the children were laughing at her. This was based upon my assumption that the dream had to do with some childhood memory involving her sister and herself of which she was ashamed of and the shame was finding expression by showing children mocking and laughing at her. I knew that she had been sexually abused as a child which when growing up was like a shameful secret that had to be hidden from other children. Therefore hearing children laughing could have been connected with her childhood fear of others finding out this secret and laughing at her.

But the patient categorically rejected that construction. "No the kids were not laughing at me. It was the laughter of children that makes a house home. It made one aware as to how fun it is to have kids laughing and playing in the house."

"Who were the kids?"

"They are my nieces and nephews. One was my older sister's and the remaining four were my younger sister's, the one who appears in the dream and tempts me with methamphetamine."

"Why do two of those children not have faces?"

"My sister is negligent towards her children. She lost custody of two of them. In fact I never saw those two. So I know of their existence but can't put a face to their names. So the dream made them faceless. My sister has no right to have those kids. All she cares for is drugs and being with men who feed her habit. She is 21 but living with a man in his fifties. She is so promiscuous. She has 4 kids already and all four with different men. Though she might as well  have not had them for she has no time for anything but sex and drugs."

Now I know this patient somewhat, and I knew that her sister and her both had been sexually abused by the boyfriend of an aunt. Since they both had been sexually stimulated at a very early age they have tremendously strong sex drive though pregenital in nature. It flows towards older men, it causes both of them more pain and suffering than pleasure, and has made them highly obsessive-compulsive as a strategy to control their tremendous temptation to act out the childhood trauma - the inexorable repetition-compulsion. The younger sister as mentioned lives with a man old enough to be her grandfather and patient while just 23 lives with someone who is in his thirties.

Based upon some of her previous dreams which show that she nightly visits the trauma of her childhood  I made the following construction:

"Is your sister's asking you to do methamphetamine is actually her asking you to do the sexual activities that you were subjected to as a child? Since both of you were abused by the same man, she and you know what exactly the experience was like, and so it is replaced by the euphemism of doing methamphetamine.

"I never thought of that, but now that you say that I do remember when he was abusing me he did make me do drugs. Yes we did cocaine and methamphetamine. I must have guessed my sister was being offered the same drugs by him. So her asking me to do methamph may be her tempting me to start behaving like her, become promiscuous and do drugs, which I do not want to."

"Why does the football player come in the first dream?"

"It is once again temptation to get sexually active. The man who abused us would praise us to make us not dislike what he was doing to us."

"Are the children's joyous laughter there to show your envy of your sister having children?"

"Yes. My sister who is so promiscuous and who does not care for children has four of them while I cannot even get pregnant. My aunt told me if I get pregnant I would look so beautiful but I guess that is never to be. For I have never been able to get pregnant. Not even once."

"Why do you tell your sister she is stupid?"

"Because methamphetamine can cause all kinds of problems with your skin. I looked up in the book its side effects. It can really destroy you. So I was warning her that it is stupid to do it."

This warning and trying to save the sister was interpreted as reaction against the impulse to cause her harm out of jealousy. The presence of the laughing children in the dream was also a form of punishment - wishing her side effects from doing methamphetamine/indulging in promiscuity. Its logic went something like this: it serves you right not having children like your sister because you have evil thoughts towards her and wish her to come down with some illness due to promiscuity.